Donor Designation Form

Community Service Assocation

501(c)(3) Charitable Nonprofit Organization

The Community Service Association of San Diego Unified School District is a nonprofit association organized to solicit contributions from district employees for recognized charitable agencies in San Diego County which supports the arts, education, health, and human services.

  • You may designate your donation to the San Diego County nonprofit agency of your choice, OR, no specific designation is required. Donations which are not designated will be allocated by the CSA Board of Directors to grant applicants.
  • If donating to a school, you must designate the school ASB or the school Foundation.
  • Minimum contribution of $5 to designate a specific charity.
  • Your donation will continue to be designated as selected until you complete a new form or edit in Peoplesoft self-service.
  • Questions? Contact John Ortler, CSA Secretary/Treasurer, via email at [email protected]
Custom Form

CSA Member Information

Name

District ID

Phone number

Email address

Location Number/Location Name

Please select one of the following:

  I am a new member and have mailed in a Voluntary Payroll Deduction Form.
  I am a new member and have submitted a Voluntary Payroll Deduction Form through PeopleSoft.
  I am a current member and am changing my contribution. I have either mailed or submitted through Peoplesoft a Voluntary Payroll Deduction Form.
  I am a current member and am not changing my contribution.

Monthly Contribution ($5 minimum to designate specific nonprofit agency

Check this box to donate to Partnership for Children (partnership with United Way of San Diego County)

  Partnership for Children

Check this box to donate to a specific nonprofit agency of your choice
  Specific charity of my choice

Name of nonprofit agency:

Tax ID:

Address of nonprofit agency:

City, State and Zip



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